Maternidade segura: estrutura física e organizacional de instituições habilitadas pela Rede Cegonha

Abstract

The Stork Network strategy represents a set of initiatives that involve changes in the process of care for pregnancy, childbirth and birth, linking network attention points to obstetric regulation. Therefore it is essential to continuous evaluation the quality of health services and health care performed by a team committed to the physical and organizational structure conditions, supported by an articulated management to achieve the quality of care, and consequently reduction of maternal and neonatal mortality. This study aimed to analyze the adequacy of the physical and organizational structure of maternity facilities enabled by the Stork Network. The theoretical model Quality Maternal and Newborn Care (QMNC) was adopted. It is a normative, cross-sectional study with a quantitative approach carried out in three maternity hospitals in the state of Ceará. The sample consisted of 347 puerperal mothers and 12 maternity managers. The data collection was conducted in the period from March to October 2017, through structured forms aimed at puerperal women and managers; and a checklist with evaluative indicators of the physical and organizational structure. Two techniques of data collection were used: interview and systematic observation. The study meets the ethical requirements with recognition of the Ethics Committee of the Scholl Maternity Assis Chateaubriand (MEAC) in Protocol 1.939.946. Data were compiled and analyzed by means the Statistical Package for Social Sciences (SPSS), version 20.0. The physical structure of all maternity wards was classified as inadequate, especially in cohabitation and in Care Unit Intermediate Neonatal Kangaroo. Human resources was the best evaluated in the three maternity hospitals. The Neonatal Intensive Care Unit was the only sector with the best suitability. The nurses were the professionals who were most qualified and performed the function of managers. The Maternities B and C had not implemented the Management Committees. About the degree of satisfaction, the results showed that the mothers attended at Maternity A and B were satisfied with all the resources. However the mothers of Maternity C had a high level of dissatisfaction with human resources, concerning the Reception with Risk Classification, the fact that it was not introduced to the health team, do not have the opportunity to ask questions and do not receive guidance. Most of the puerperal mothers were satisfied with the waiting time in the three maternities. The place of the companion was evaluated with dissatisfaction. It was concluded that only human resources were adequate in the maternity hospitals investigated. Very low scores for physical resources are highlighted, being classified as inadequate. The mothers attended at maternity units A and B were satisfied with all the resources, while the mothers of Maternity C had a high level of dissatisfaction with human resources.